We read with interest the articles from Casanova et al revealing impaired type I IFN immunity as a major risk for severe coronavirus disease 2019 (COVID-19)1,2; however, the relative importance of innate and adaptive immunity for viral control is difficult to evaluate.3 A diagnosis of mild COVID-19 in 2 identical twin neonates with an uncommon PID that causes athymia and almost complete T-cell lymphopenia allowed study of innate immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the absence of adaptive immunity.
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